U.S. patent application number 16/761522 was filed with the patent office on 2020-08-20 for robotic system with articulating probe and articulating camera.
The applicant listed for this patent is MEDROBOTICS CORPORATION. Invention is credited to Richard Andrews, Thomas Calef, J. Christopher Flaherty, R. Maxwell Flaherty, Jesse Mitchell.
Application Number | 20200261171 16/761522 |
Document ID | 20200261171 / US20200261171 |
Family ID | 1000004829047 |
Filed Date | 2020-08-20 |
Patent Application | download [pdf] |
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United States Patent
Application |
20200261171 |
Kind Code |
A1 |
Calef; Thomas ; et
al. |
August 20, 2020 |
ROBOTIC SYSTEM WITH ARTICULATING PROBE AND ARTICULATING CAMERA
Abstract
A system for performing a medical procedure on a patient
includes an articulating probe assembly. At least one tool is
configured to translate through one of the at least two working
channels of the probe assembly. A camera device includes a shaft
comprising an articulating distal portion with a distal end and a
camera assembly positioned on the distal end of the shaft. The
system is configured to articulate the shaft distal portion to
position the camera distal assembly outside of the probe
assembly.
Inventors: |
Calef; Thomas; (Bridgewater,
MA) ; Andrews; Richard; (North Attleboro, MA)
; Mitchell; Jesse; (Jamaica Plain, MA) ; Flaherty;
R. Maxwell; (Topsfield, MA) ; Flaherty; J.
Christopher; (Auburndale, FL) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
MEDROBOTICS CORPORATION |
Raynham |
MA |
US |
|
|
Family ID: |
1000004829047 |
Appl. No.: |
16/761522 |
Filed: |
November 6, 2018 |
PCT Filed: |
November 6, 2018 |
PCT NO: |
PCT/US18/59338 |
371 Date: |
May 5, 2020 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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62614346 |
Jan 5, 2018 |
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62582283 |
Nov 6, 2017 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2034/301 20160201;
A61B 34/30 20160201; A61B 1/008 20130101; A61B 1/018 20130101; A61B
1/00149 20130101 |
International
Class: |
A61B 34/30 20060101
A61B034/30; A61B 1/00 20060101 A61B001/00; A61B 1/008 20060101
A61B001/008; A61B 1/018 20060101 A61B001/018 |
Claims
1. A system for performing a medical procedure on a patient,
comprising: an articulating probe assembly, comprising: an inner
probe comprising multiple articulating inner links; an outer probe
surrounding the inner probe and comprising multiple articulating
outer links; a probe distal portion including an outer surface,
distal end, and a central axis, wherein the outer surface defines a
probe projection extending distally from the probe assembly and
along the central axis; and at least two working channels that exit
the probe distal end, at least one tool configured to translate
through one of the at least two working channels, and a camera
device, comprising: a shaft comprising an articulating distal
portion with a distal end; and a camera assembly positioned on the
distal end of the shaft; wherein the system is configured to
articulate the shaft distal portion to position the camera distal
assembly outside of the probe projection.
2.-37. (canceled)
Description
RELATED APPLICATIONS
[0001] This application claims the benefit of U.S. Provisional
Application No. 62/582,283, filed Nov. 6, 2017, the content of
which is incorporated herein by reference in its entirety.
[0002] This application claims the benefit of U.S. Provisional
Application No. 62/614,346, filed Jan. 5, 2018, the content of
which is incorporated herein by reference in its entirety.
[0003] This application is related to U.S. Provisional Application
No. 61/921,858, filed Dec. 30, 2013, the content of which is
incorporated herein by reference in its entirety.
[0004] This application is related to PCT Application No
PCT/US2014/071400, filed Dec. 19, 2014, PCT Publication No.
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2018/0250095 the content of which is incorporated herein by
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[0007] This application is related to U.S. Provisional Application
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incorporated herein by reference in its entirety.
[0008] This application is related to PCT Application No
PCT/US2011/057282, filed Oct. 21, 2011, PCT Publication No.
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entirety.
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No. 14/587,166, filed Dec. 31, 2014, U.S. Publication No.
2015/0313449, the content of which is incorporated herein by
reference in its entirety.
[0011] This application is related to U.S. Provisional Application
No. 61/492,578, filed Jun. 2, 2011, the content of which is
incorporated herein by reference in its entirety.
[0012] This application is related to PCT Application No.
PCT/US2012/040414, filed Jun. 1, 2012, PCT Publication No.
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[0014] This application is related to U.S. Provisional Application
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incorporated herein by reference in its entirety.
[0015] This application is related to PCT Application No.
PCT/US2018/031774, filed May 9, 2018, the content of which is
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[0016] This application is related to U.S. Provisional Application
No. 61/412,733, filed Nov. 11, 2010, the content of which is
incorporated herein by reference in its entirety.
[0017] This application is related to PCT Application No
PCT/US2011/060214, filed Nov. 10, 2011, PCT Publication No.
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No. 13/884,407, filed May 9, 2013, U.S. Publication No.
2014/0012288, now U.S. Pat. No. 9,649,163, issued on May 16, 2017,
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entirety.
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No. 15/587,832, filed May 5, 2017, U.S. Publication No.
2018/0021095, the content of which is incorporated herein by
reference in its entirety.
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No. 61/472,344, filed Apr. 6, 2011, the content of which is
incorporated herein by reference in its entirety.
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PCT/US2012/032279, filed Apr. 5, 2012, PCT Publication No.
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entirety.
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No. 14/944,665, filed Nov. 18, 2015, U.S. Publication No.:
2016/0066938, the content of which is incorporated herein by
reference in its entirety.
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No. 14/945,685, filed Nov. 19, 2015, U.S. Publication No.
2016/0066939, the content of which is incorporated herein by
reference in its entirety.
[0025] This application is related to U.S. Provisional Application
No. 61/534,032 filed Sep. 13, 2011, the content of which is
incorporated herein by reference in its entirety.
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PCT/US2012/054802, filed Sep. 12, 2012, PCT Publication No.
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entirety.
[0029] This application is related to U.S. patent application Ser.
No. 15/684,268, filed Aug. 23, 2017, U.S. Publication No.
2017/0368681, the content of which is incorporated herein by
reference in its entirety.
[0030] This application is related to U.S. Provisional Application
No. 61/368,257, filed Jul. 28, 2010, the content of which is
incorporated herein by reference in its entirety.
[0031] This application is related to PCT Application No
PCT/US2011/044811, filed Jul. 21, 2011, PCT Publication No.
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[0033] This application is related to U.S. patent application Ser.
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2018-0206923 the content of which is incorporated herein by
reference in its entirety.
[0034] This application is related to U.S. Provisional Application
No. 61/578,582, filed Dec. 21, 2011, the content of which is
incorporated herein by reference in its entirety.
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PCT/US2012/070924, filed Dec. 20, 2012, PCT Publication No.
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No. 15/786,901, filed Oct. 18, 2017, U.S. Publication No.
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reference in its entirety.
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No. 61/681,340, filed Aug. 9, 2012, the content of which is
incorporated herein by reference in its entirety.
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PCT/US2013/054326, filed Aug. 9, 2013, PCT Publication No.
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2018/0021060, the content of which is incorporated herein by
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PCT/US2014/010808, filed Jan. 9, 2014, PCT Publication No.
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PCT/US2013/043858, filed Jun. 3, 2013, PCT Publication No.
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reference in its entirety.
[0049] This application is related to U.S. Provisional Application
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incorporated herein by reference in its entirety.
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PCT/US2013/038701, filed May 20, 2014, PCT Publication No.
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entirety.
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No. 15/350,549, filed Nov. 14, 2016, U.S. Publication No.
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its entirety.
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No. 16/020,115, filed Jun. 27, 2018, the content of which is
incorporated herein by reference in its entirety.
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PCT/US2014/036571, filed May 2, 2014, PCT Publication No.
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2016/0067000, now U.S. Pat. No. 9,913,695, issued on Mar. 13, 2018,
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entirety.
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No. 15/916,664, filed Mar. 9, 2018, U.S. Publication No.
2018/0256269, the content of which is incorporated herein by
reference in its entirety.
[0058] This application is related to U.S. Provisional Application
No. 61/909,605, filed Nov. 27, 2013, the content of which is
incorporated herein by reference in its entirety.
[0059] This application is related to U.S. Provisional Application
No. 62/052,736, filed Sep. 19, 2014, the content of which is
incorporated herein by reference in its entirety.
[0060] This application is related to PCT Application No.
PCT/US2014/067091, filed Nov. 24, 2014, PCT Publication No.
WO2015/081008, the content of which is incorporated herein by
reference in its entirety.
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No. 15/038,531, filed May 23, 2016, U.S. Publication No.
2016/0287224, the content of which is incorporated herein by
reference in its entirety.
[0062] This application is related to U.S. Provisional Application
No. 62/008,453 filed Jun. 5, 2014, the content of which is
incorporated herein by reference in its entirety.
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PCT/US2015/034424, filed Jun. 5, 2015, PCT Publication No.
WO2015/188071, the content of which is incorporated herein by
reference in its entirety.
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No. 15/315,868, filed Dec. 2, 2016, U.S. Publication No.
2017/0100197, the content of which is incorporated herein by
reference in its entirety.
[0065] This application is related to U.S. Provisional Application
No. 62/150,223, filed Apr. 20, 2015, the content of which is
incorporated herein by reference in its entirety.
[0066] This application is related to U.S. Provisional Application
No. 62/299,249, filed Feb. 24, 2016, the content of which is
incorporated herein by reference in its entirety.
[0067] This application is related to PCT Application No.
PCT/US2016/028374, filed Apr. 20, 2016, PCT Publication No.
WO2016/172162, the content of which is incorporated herein by
reference in its entirety.
[0068] This application is related to U.S. patent application Ser.
No. 15/567,109, filed Oct. 17, 2017, U.S. Publication No.
2018-0228557 the content of which is incorporated herein by
reference in its entirety.
[0069] This application is related to U.S. Provisional Application
No. 62/401,390, filed Sep. 29, 2016, the content of which is
incorporated herein by reference in its entirety.
[0070] This application is related to PCT Application No.
PCT/US2017/054297, filed Sep. 29, 2017, PCT Publication No.
WO2018/064475, the content of which is incorporated herein by
reference in its entirety.
[0071] This application is related to U.S. Provisional Application
No. 62/517,433, filed Jun. 9, 2017, the content of which is
incorporated herein by reference in its entirety.
[0072] This application is related to PCT Application No.
PCT/US2018/036876, filed Jun. 11, 2018, the content of which is
incorporated herein by reference in its entirety.
[0073] This application is related to U.S. Provisional Application
No. 62/481,309, filed Apr. 4, 2017, the content of which is
incorporated herein by reference in its entirety.
[0074] This application is related to U.S. Provisional Application
No. 62/598,812, filed Dec. 14, 2017, the content of which is
incorporated herein by reference in its entirety.
[0075] This application is related to U.S. Provisional Application
No. 62/617,513, filed Jan. 15, 2018, the content of which is
incorporated herein by reference in its entirety.
[0076] This application is related to PCT Application No.
PCT/US2018/026016, filed Apr. 4, 2018, PCT Publication No.
WO2018/187425 the content of which is incorporated herein by
reference in its entirety.
[0077] This application is related to U.S. Provisional Application
No. 62/533,644, filed Jul. 17, 2017, the content of which is
incorporated herein by reference in its entirety.
[0078] This application is related to U.S. Provisional Application
No. 62/614,263, filed Jan. 5, 2018, the content of which is
incorporated herein by reference in its entirety.
[0079] This application is related to PCT Application No.
PCT/US2017/042449, filed Jul. 17, 2018, PCT Publication No.
WO2018/xxxxxx, the content of which is incorporated herein by
reference in its entirety.
[0080] This application is related to U.S. Provisional Application
No. 62/613,899, filed Jan. 5, 2018, the content of which is
incorporated herein by reference in its entirety.
[0081] This application is related to U.S. Provisional Application
No. 62/614,223, filed Jan. 5, 2018, the content of which is
incorporated herein by reference in its entirety.
[0082] This application is related to U.S. Design application Ser.
No. 29/632,148, filed Jan. 5, 2018, the content of which is
incorporated herein by reference in its entirety.
[0083] This application is related to U.S. Provisional Application
No. 62/614,224, filed Jan. 5, 2018, the content of which is
incorporated herein by reference in its entirety.
[0084] This application is related to U.S. Provisional Application
No. 62/614,228, filed Jan. 5, 2018, the content of which is
incorporated herein by reference in its entirety.
[0085] This application is related to U.S. Provisional Application
No. 62/614,225, filed Jan. 5, 2018, the content of which is
incorporated herein by reference in its entirety.
[0086] This application is related to U.S. Provisional Application
No. 62/614,240, filed Jan. 5, 2018, the content of which is
incorporated herein by reference in its entirety.
[0087] This application is related to U.S. Provisional Application
No. 62/614,235, filed Jan. 5, 2018, the content of which is
incorporated herein by reference in its entirety.
[0088] This application is related to U.S. Pat. No. 9,011,318,
issued Apr. 21, 2015, the content of which is incorporated herein
by reference in its entirety.
FIELD
[0089] The present inventive concepts generally relate to the field
of surgical instruments, and more particularly, to articulated
probe assemblies, systems and methods incorporating the same, and
systems and methods for performing a surgical procedure.
BACKGROUND
[0090] As less invasive medical techniques and procedures become
more widespread, medical professionals such as surgeons may require
articulating surgical tools, such as endoscopes, to perform such
less invasive medical techniques and procedures that require access
to locations within the patient, such as a site accessible through
the mouth or other natural orifice, or a site accessible through an
incision through the patient's skin.
[0091] There is a need for improved systems for performing a
medical procedure.
SUMMARY
[0092] According to an aspect of the present inventive concepts, a
system for performing a medical procedure on a patient, comprising:
an articulating probe assembly, comprising: an inner probe
comprising multiple articulating inner links; an outer probe
surrounding the inner probe and comprising multiple articulating
outer links; a probe distal portion including an outer surface,
distal end, and a central axis, wherein the outer surface defines a
probe projection extending distally from the probe assembly and
along the central axis; and at least two working channels that exit
the probe distal end; at least one tool configured to translate
through one of the at least two working channels, and a camera
device, comprising: a shaft comprising an articulating distal
portion with a distal end; and a camera assembly positioned on the
distal end of the shaft; wherein the system is configured to
articulate the shaft distal portion to position the camera distal
assembly outside of the probe projection.
[0093] In some embodiments, the medical procedure comprises a
trans-vaginal procedure.
[0094] In some embodiments, the medical procedure comprises a
trans-abdominal procedure.
[0095] In some embodiments, the probe distal portion comprises
multiple links.
[0096] In some embodiments, the probe distal portion comprises a
wrist portion. The probe distal portion can further comprise an
elbow portion.
[0097] In some embodiments, the camera assembly includes a CCD
camera.
[0098] In some embodiments, the camera device includes an optical
fiber and the camera assembly includes a lens optically connected
to the optical fiber.
[0099] In some embodiments, the camera device comprises a 3D
camera.
[0100] In some embodiments, the articulating distal portion of the
camera device shaft articulates distal to the distal end of the
probe.
[0101] In some embodiments, the probe distal portion comprises a
slot, and the articulating distal portion of the camera device
shaft articulates through the slot.
[0102] In some embodiments, the system is configured to rotate the
camera assembly to an outwardly rotated position. The system can
further comprise a control which when activated causes the rotation
of the camera assembly. Activation of the control can cause the
inner probe and the outer probe to lock. Activation of the control
can cause the at least one tool to transition to an unlocked state.
Activation of the control can cause an image provided by the system
to rotate. Activation of the control can cause an image calibration
procedure to be performed. The system can further comprise at least
one control configured to alternatingly control both the probe
assembly and the at least one tool, and the system can be
configured to rotate the camera assembly when the control changes
from controlling the probe to controlling the at least one tool.
The system can be further configured to automatically rotate the
camera assembly to an outwardly rotated position. The system can
further comprise a control to advance the at least one tool, and
the automatic rotation occurs when the control can be activated.
The automatic rotation can occur when the system transitions to a
state in which the inner probe can be locked and the outer probe
can be locked.
[0103] In some embodiments, the system is configured to prevent
advancement of the at least one tool if the camera assembly is not
in an outwardly rotated position.
[0104] In some embodiments, the medical procedure is performed at a
target location comprising an equivalent diameter, and the probe
comprises an outer diameter, and the target location diameter is at
least two times, at least three times, at least four times the
outer diameter of the probe.
[0105] In some embodiments, one of the inner probe or the outer
probe is configured to transition between a rigid mode and a
flexible mode, and the other of the inner probe or the outer probe
is configured to transition between a rigid mode and a flexible
mode and to be steered. The outer probe can be configured to be
steered.
[0106] In some embodiments, the articulating probe is constructed
and arranged to be inserted into a natural orifice of the patient.
The natural orifice can comprise at least one of the anus, vagina,
meatus, nostril, mouth, ear, and combinations thereof.
[0107] In some embodiments, the articulating probe is constructed
and arranged to be inserted through an incision in the patient.
[0108] In some embodiments, the at least one tool comprises a
flexible tool.
[0109] In some embodiments, the at least one tool comprises a rigid
tool.
[0110] In some embodiments, the at least one tool comprises at
least one of a laser delivery element, scissor, blade, cautery
element, suction element, irrigation element, grasper, surgical
stapler or other tissue securing element, and combinations
thereof.
[0111] According to another aspect of the present inventive
concepts, a method of operating an articulating probe, wherein the
articulating probe is advanced through a luminal pathway, the
method comprising: introducing the articulating probe proximate a
proximal end of a luminal pathway, the articulating probe
comprising an inner and an outer probe and wherein the inner and
outer probes each include a plurality of links with a distal-most
link; the articulating probe further comprising a camera device
including a shaft and a camera assembly on the distal end of the
shaft; and advancing both the inner and outer probes of the
articulating probe in a double limp mode, wherein the inner and
outer probe simultaneously advance each in a limp state within the
luminal pathway; transitioning the inner probe from the limp state
to a rigid state; continue advancing the articulating probe in a
follow the leader mode, comprising: advancing the limp outer probe
such that its distal-most link extends at least one link's length
beyond the distal-most link of the inner probe, wherein the rigid
inner probe is not advanced; transitioning the outer probe from the
limp state to a rigid state and the inner probe from the rigid
state to the limp state; and advancing the limp inner probe such
that its distal-most link is coextensive with the distal-most link
of the outer probe, wherein the rigid outer probe is not advanced;
and wherein the inner and outer probes are alternatingly advanced
to approach at least one target location within the luminal
pathway, and wherein the inner and/or outer probes are steerable in
the limp state; rotating the camera assembly to an outwardly
rotated position; performing at least one procedure at the at least
one target location; and retracting the articulating probe from the
luminal pathway such that both the inner and outer probes are
retracted in the double limp mode and/or the follow the leader
mode.
[0112] In some embodiments, the limp outer probe can be advanced
such that its distal-most link extends between two and twenty
link's length beyond the distal-most link of the inner probe.
[0113] In some embodiments, the method further comprises
articulating the shaft of the camera device to reposition the
camera assembly.
[0114] In some embodiments, the articulating probe includes a
slotted distal portion, and the shaft articulates through the
slot.
[0115] The technology described herein, along with the attributes
and attendant advantages thereof, will best be appreciated and
understood in view of the following detailed description taken in
conjunction with the accompanying drawings in which representative
embodiments are described by way of example.
BRIEF DESCRIPTION OF THE DRAWINGS
[0116] FIG. 1 illustrates a schematic view of a system for
performing a medical procedure, consistent with the present
inventive concepts.
[0117] FIGS. 2A-C illustrate graphic demonstrations of an
articulating probe, consistent with the present inventive
concepts.
[0118] FIGS. 3A and B illustrate schematic views of the distal
portion of an articulated probe including a camera device and a
tool, consistent with the present inventive concepts.
[0119] FIGS. 4A and B illustrate schematic views of the distal
portion of an articulated probe including a slotted distal portion,
a camera device, and a tool, consistent with the present inventive
concepts.
[0120] FIGS. 5A-D illustrate a sequence of schematic drawings of
advancing a camera device from a confined space, consistent with
the present inventive concepts.
[0121] FIG. 6 illustrates a perspective view of a probe system
including a camera device and multiple tools in a triangulated
position, consistent with the present inventive concepts.
[0122] FIGS. 7A and 7B illustrate perspective views of a camera
from the front and back, consistent with the present inventive
concepts.
[0123] FIGS. 8A and 8B illustrate perspective views of a camera
operably attached to a surgical tool, consistent with the present
inventive concepts.
[0124] FIG. 9A illustrates a perspective view of a camera
connector, consistent with the present inventive concepts.
[0125] FIGS. 9B-D illustrate perspective views of a camera cable
adaptor, consistent with the present inventive concepts.
[0126] FIGS. 10A and 10B illustrate a perspective view and a
sectional perspective view of a distal link, respectively,
consistent with the present inventive concepts.
DETAILED DESCRIPTION
[0127] Reference will now be made in detail to the present
embodiments of the technology, examples of which are illustrated in
the accompanying drawings. Similar reference numbers may be used to
refer to similar components. However, the description is not
intended to limit the present disclosure to particular embodiments,
and it should be construed as including various modifications,
equivalents, and/or alternatives of the embodiments described
herein.
[0128] It will be understood that the words "comprising" (and any
form of comprising, such as "comprise" and "comprises"), "having"
(and any form of having, such as "have" and "has"), "including"
(and any form of including, such as "includes" and "include") or
"containing" (and any form of containing, such as "contains" and
"contain") when used herein, specify the presence of stated
features, integers, steps, operations, elements, and/or components,
but do not preclude the presence or addition of one or more other
features, integers, steps, operations, elements, components, and/or
groups thereof.
[0129] It will be further understood that, although the terms
first, second, third etc. may be used herein to describe various
limitations, elements, components, regions, layers and/or sections,
these limitations, elements, components, regions, layers and/or
sections should not be limited by these terms. These terms are only
used to distinguish one limitation, element, component, region,
layer or section from another limitation, element, component,
region, layer or section. Thus, a first limitation, element,
component, region, layer or section discussed below could be termed
a second limitation, element, component, region, layer or section
without departing from the teachings of the present
application.
[0130] It will be further understood that when an element is
referred to as being "on", "attached", "connected" or "coupled" to
another element, it can be directly on or above, or connected or
coupled to, the other element, or one or more intervening elements
can be present. In contrast, when an element is referred to as
being "directly on", "directly attached", "directly connected" or
"directly coupled" to another element, there are no intervening
elements present. Other words used to describe the relationship
between elements should be interpreted in a like fashion (e.g.
"between" versus "directly between," "adjacent" versus "directly
adjacent," etc.).
[0131] It will be further understood that when a first element is
referred to as being "in", "on" and/or "within" a second element,
the first element can be positioned: within an internal space of
the second element, within a portion of the second element (e.g.
within a wall of the second element); positioned on an external
and/or internal surface of the second element; and combinations of
one or more of these.
[0132] As used herein, the term "proximate" shall include locations
relatively close to, on, in and/or within a referenced component,
anatomical location, or other location.
[0133] Spatially relative terms, such as "beneath," "below,"
"lower," "above," "upper" and the like may be used to describe an
element and/or feature's relationship to another element(s) and/or
feature(s) as, for example, illustrated in the figures. It will be
further understood that the spatially relative terms are intended
to encompass different orientations of the device in use and/or
operation in addition to the orientation depicted in the figures.
For example, if the device in a figure is turned over, elements
described as "below" and/or "beneath" other elements or features
would then be oriented "above" the other elements or features. The
device can be otherwise oriented (e.g. rotated 90 degrees or at
other orientations) and the spatially relative descriptors used
herein interpreted accordingly.
[0134] The terms "reduce", "reducing", "reduction" and the like,
where used herein, are to include a reduction in a quantity,
including a reduction to zero. Reducing the likelihood of an
occurrence shall include prevention of the occurrence.
[0135] The term "and/or" where used herein is to be taken as
specific disclosure of each of the two specified features or
components with or without the other. For example, "A and/or B" is
to be taken as specific disclosure of each of (i) A, (ii) B and
(iii) A and B, just as if each is set out individually herein.
[0136] In this specification, unless explicitly stated otherwise,
"and" can mean "or," and "or" can mean "and." For example, if a
feature is described as having A, B, or C, the feature can have A,
B, and C, or any combination of A, B, and C. Similarly, if a
feature is described as having A, B, and C, the feature can have
only one or two of A, B, or C.
[0137] The expression "configured (or set) to" used in the present
disclosure may be used interchangeably with, for example, the
expressions "suitable for", "having the capacity to", "designed
to", "adapted to", "made to" and "capable of" according to a
situation. The expression "configured (or set) to" does not mean
only "specifically designed to" in hardware. Alternatively, in some
situations, the expression "a device configured to" may mean that
the device "can" operate together with another device or
component.
[0138] As described herein, "room pressure" shall mean pressure of
the environment surrounding the systems and devices of the present
inventive concepts. Positive pressure includes pressure above room
pressure or simply a pressure that is greater than another
pressure, such as a positive differential pressure across a fluid
pathway component such as a valve. Negative pressure includes
pressure below room pressure or a pressure that is less than
another pressure, such as a negative differential pressure across a
fluid component pathway such as a valve. Negative pressure can
include a vacuum but does not imply a pressure below a vacuum. As
used herein, the term "vacuum" can be used to refer to a full or
partial vacuum, or any negative pressure as described
hereabove.
[0139] The term "diameter" where used herein to describe a
non-circular geometry is to be taken as the diameter of a
hypothetical circle approximating the geometry being described. For
example, when describing a cross section, such as the cross section
of a component, the term "diameter" shall be taken to represent the
diameter of a hypothetical circle with the same cross-sectional
area as the cross section of the component being described.
[0140] The terms "major axis" and "minor axis" of a component where
used herein are the length and diameter, respectively, of the
smallest volume hypothetical cylinder which can completely surround
the component.
[0141] It is appreciated that certain features of the invention,
which are, for clarity, described in the context of separate
embodiments, may also be provided in combination in a single
embodiment. Conversely, various features of the invention which
are, for brevity, described in the context of a single embodiment,
may also be provided separately or in any suitable sub-combination.
For example, it will be appreciated that all features set out in
any of the claims (whether independent or dependent) can be
combined in any given way.
[0142] It is to be understood that at least some of the figures and
descriptions of the invention have been simplified to focus on
elements that are relevant for a clear understanding of the
invention, while eliminating, for purposes of clarity, other
elements that those of ordinary skill in the art will appreciate
may also comprise a portion of the invention. However, because such
elements are well known in the art, and because they do not
necessarily facilitate a better understanding of the invention, a
description of such elements is not provided herein.
[0143] Terms defined in the present disclosure are only used for
describing specific embodiments of the present disclosure and are
not intended to limit the scope of the present disclosure. Terms
provided in singular forms are intended to include plural forms as
well, unless the context clearly indicates otherwise. All of the
terms used herein, including technical or scientific terms, have
the same meanings as those generally understood by an ordinary
person skilled in the related art, unless otherwise defined herein.
Terms defined in a generally used dictionary should be interpreted
as having meanings that are the same as or similar to the
contextual meanings of the relevant technology and should not be
interpreted as having ideal or exaggerated meanings, unless
expressly so defined herein. In some cases, terms defined in the
present disclosure should not be interpreted to exclude the
embodiments of the present disclosure.
[0144] Provided herein are systems for performing a medical
procedure, such as a trans-vaginal or trans-abdominal medical
procedure performed at a target location within a patient. The
systems include an articulating probe assembly, at least one tool,
and a camera device that includes a shaft with a distal end, and a
camera assembly on the distal end of the shaft. The articulating
probe assembly comprises an inner probe comprising multiple
articulating inner links; an outer probe surrounding the inner
probe and comprising multiple articulating outer links; and a probe
distal portion including an outer surface, distal end, and a
central axis. The outer surface defines a probe projection
extending distally from the probe assembly and along the central
axis. The probe assembly can further include one or more working
channels that slidingly receive one or more tools, and/or at least
one working channel that slidingly surrounds the shaft of the
camera device. The shaft of the camera device can include one or
more articulating portions, such as portions including
articulatable links. The system is configured to allow an operator
to articulate the shaft of the camera device to position the camera
distal assembly outside of the probe projection. In some
embodiments, the probe assembly includes a slot extending
proximally from the distal end of the probe assembly, and the shaft
of the camera device can be articulated through the slot.
[0145] Referring now to FIG. 1, a schematic view of a system for
performing a medical procedure is illustrated, consistent with the
present inventive concepts. System 10 includes an articulating
probe assembly, probe 300, one or more tools, such as tool 200
shown, and a camera device, camera 100. System 10 can be used to
perform a surgical procedure at a target location within a
patient's body cavity. The target location can comprise a location
within: the colon; the intestine; the esophagus; a nasal
passageway; the vaginal canal; an ear canal; an artificially
insufflated cavity in the abdomen; and/or other body lumen or body
location. Additionally, the target location can comprise a 3D space
comprising an equivalent diameter as defined herein. In some
embodiments, system 10 provides access to the target location via
an orifice selected from the group consisting of: the anus; the
vagina; the meatus (distal end of the urethra); a nostril; the
mouth; an ear; a surgical incision; and combinations of one or more
of these.
[0146] Probe 300 includes an inner probe 310 comprising multiple
inner links 315 and an outer probe 350 comprising multiple outer
links 355 and slidingly surrounding inner probe 310. Probe 300
includes a distal portion 301 configured to be steered. Distal
portion 301 can comprise an outer diameter. In some embodiments,
the target location comprises a diameter at least two times, at
least three times, or at least four times the outer diameter of
distal portion 301. In some embodiments, distal portion 301
comprises a slot 3561, as described herebelow in reference to FIGS.
4A-B. Articulating probe 300 can be constructed and arranged as is
described in reference to applicant's co-pending U.S. patent
application Ser. No. 15/378,723, filed Dec. 14, 2016, the contents
of which are incorporated herein by reference in their entirety for
all purposes, and/or as described in further detail herebelow in
reference to FIGS. 2A-C. Outer probe 350 can comprise one or more
steering cables, cables 351, configured to steer outer probe 350,
and/or transition outer probe 350 between limp and rigid states, as
described herein. Inner probe 310 can comprise one or more steering
cables, cables 311, also configured to steer inner probe 310 and/or
transition inner probe 310 between limp and rigid states. In some
embodiments, only one of outer probe 350 or inner probe 310 is
steered, while both can transition between limp and rigid states.
Probe 300 includes at least two working channels, such as channels
356a-d shown (generally channels 356). Channels 356 can comprise
channels positioned between mating recesses between the outer
surface of inner probe 310 and the inner surface of outer probe
350.
[0147] Distal portion 301 of outer probe 300 can comprise at least
a distal most link, distal link 355. Distal portion 301 includes an
outer surface, and a central axis Ai extending along the path of
probe 300 proximal to distal link 355, and normal to the distal
face of distal link 355D distally. The outer surface, projected
distally along this axis defines a "probe projection", PPRJ,
extending beyond the distal end of probe 300.
[0148] Tool 200 comprises one or more tools that can be inserted
into and translated within channels 356. Tool 200 can comprise
flexible tools and/or rigid tools with end effectors 205. Tool 200
can comprise one, two, three, or more tools selected from the group
consisting of: a laser delivery element; a scissor; a blade; a
cautery element; a suction element (e.g. a nozzle operably
connected to a vacuum source); an irrigation element (e.g. a nozzle
operably connected to an irrigation source); a grasper; a surgical
stapler or other tissue securing element; and combinations
thereof.
[0149] Camera device 100 comprises an elongate device including
shaft 110 and camera assembly 120 positioned on the distal end of
shaft 110. In some embodiments, camera device 100 comprises a 3-D
camera. Shaft 110 comprises multiple links 113 configured to
articulate relative to each other, via articulation caused by
tensioning of one or more cables, cable 101 shown. Shaft 110 can
include one, two, three, or more independently articulatable
segments, such as to enable a "wrist and elbow" type configuration,
allowing articulation of camera device 100 in separate, independent
directions. For example, shaft 110 can include two independently
articulatable segments, articulating portion 111, comprising
multiple links 113, and articulating portion 112, comprising
multiple links 113. In some embodiments, first articulating portion
111 can be constructed and arranged to articulate in a single
degree of freedom, and second articulating portion 112 can be
constructed and arranged to articulate in two degrees of freedom.
In some embodiments, links 113 comprise hinged links that alternate
in alternating directions from link to link (e.g. 90.degree.
alternating links, such that three consecutive links enable
articulation in 2 degrees of freedom). In some embodiments, links
113 of first articulating portion 111 do not alternate, and only
articulate in a single direction, enabling a tighter radius of
curvature for articulating portion 111 (e.g. tighter than that of
articulating section 112). Camera assembly 120 can include one or
more light capturing elements, lenses 122, and one or more
illumination sources, lights 121. Lens 122 can direct light from
outside camera assembly 120 to one or more sensors (e.g. CCD
sensors) within camera assembly 120 and/or into one or more optical
fibers, such as an optical fiber positioned through camera assembly
100 and optically attached to one or more sensors proximal to
camera assembly 120 (e.g. imaging sensor positioned outside of
probe 300). Camera assembly 120 can be constructed and arranged as
is described in reference to applicant's co-pending International
PCT Patent Application Serial Number PCT/US2017/054297, titled
"Optical Systems For Surgical Probes, Systems And Methods
Incorporating The Same, And Methods For Performing Surgical
Procedures", filed Sep. 29, 2017, the content of which is
incorporated herein in its entirety for all purposes. Additionally
or alternatively, camera assembly 120 can be of similar
construction and arrangement to the similar devices described in
applicant's co-pending application U.S. Provisional Application No.
62/614,225, filed Jan. 5, 2018, "Robotically Controlled Surgical
Tool", by Mitchell, et al., the content of which is incorporated
herein by reference in its entirety.
[0150] Shaft 110 of camera device 100 can be slidingly positioned
within and exiting the distal end of a channel 356 (channel 356a
shown) of probe 300, with camera assembly 120 positioned distal to
the distal end of probe 300 (e.g. all articulation of camera device
100 is beyond the distal end of probe 300). In a first orientation,
camera assembly 120 can be positioned within the region PPRJ of
probe 300, such that camera assembly 120 is aligned with the distal
portion 301 of probe 300. Additionally, camera assembly 120 can be
positioned close to and/or abutting distal link 355D, relatively
covering the distal end of one or more working channels 356 (e.g.
in that alignment preventing one or more tools 200 from exiting the
distal end of working channels 356). Camera device 100 can be
advanced, such that camera assembly 120 moves distally from distal
link 355D, allowing one or more tools 200 to exit working channels
356, as shown in FIGS. 3A-B and 4A-B. In some embodiments, shaft
110 can operably attach to camera assembly 120 offset from the
center axis of camera assembly 120. In these embodiments, camera
device 100, or at least camera assembly 120, can be rotated to an
outwardly rotated position, such as a rotation of approximately
180.degree., such as to reposition camera assembly 120 outside of
the region PPRJ of probe 300, providing clearance for one or more
tools 200 to exit working channels 356, as shown in FIGS. 5A-D.
[0151] System 10 can be configured to rotate camera assembly 120 to
the outwardly rotated position via a control 53 of user interface
52. Control 53 can be configured to cause at least one of the
following to occur in addition to rotating camera assembly 120:
lock inner probe 310; lock outer probe 350; lock inner probe 310
and outer probe 350; transition tool 200 to an unlocked state;
rotate an image provided by system 10, such as to adjust for the
camera rotation; perform an image calibration procedure; and
combinations thereof.
[0152] In some embodiments, system 10 is configured to
automatically rotate camera assembly 120 to the outwardly rotated
position. Control 53 can be configured to alternatingly control
both probe 300 and a tool 200, such that control 53 rotates camera
assembly 120 automatically when control 53 changes from controlling
probe 300 to controlling a tool 200. In some embodiments, control
53 can advance tool 200 such that before tool 200 is advanced
beyond the distal end of probe 300, camera assembly 120 is rotated
automatically (e.g. automatic rotation of camera assembly 120 prior
to the advancement of tool 200 beyond the distal end of probe 300).
System 10 can be configured to automatically rotate camera assembly
120 to the outwardly rotated position when system 10 transitions to
a state in which inner probe 310 is locked and outer probe 350 is
locked (e.g. either or both probes 310, 350 is locked and the other
transitions to locked, or both probes 310, 350 transition to
locked). System 10 can be configured to prevent advances of tool
200 if camera assembly 120 is not in the outwardly rotated
position.
[0153] In some embodiments, the camera position is robotically
controlled independent of the probe and instrument positions, such
as to allow the user to choose optimal viewing angle for a given
procedure and set of instruments. In some embodiments, the camera
can be positioned to view instruments as they are introduced into
the surgical field, and then repositioned to follow the instruments
to the surgical site. As the needs of the user change during the
procedure, the camera can be repositioned accordingly.
[0154] In some embodiments, the camera can be detached from a
robotic instrument at distal tip, such as to allow for camera
sterilization separate from an instrument, and to allow for a
replacement of damaged cameras or instruments. In FIGS. 7A-B, the
camera assembly (including a camera cable) is shown removed from a
robotic instrument. In FIGS. 8A-B, the camera assembly is shown
attached to a robotic instrument (e.g. with the camera cable
extending through the instrument.
[0155] In some embodiments, the camera attachment point is
positioned on a centerline of the housing, at a top edge of
proximal cap, such that: the cable can be routed through the
attachment point (distal link) and center lumen of the camera
instrument; there is no need for exterior routing along probe path
(e.g. it does not impact probe OD); the camera can be pivoted along
its centerline; the camera can be positioned within the OD of the
probe during probe introduction, and then pivoted 180.degree. to
allow instruments to be introduced through their channels; and the
camera can achieve a steeper viewing angle when visualizing
instrument introduction (e.g. to reduce the "blind spot" at the
distal tip and allow the user to visualize the instruments sooner
as they are introduced). The camera attachment point is illustrated
in FIGS. 7A-8B
[0156] In some embodiments, a custom camera connector has an OD of
approximately 0.105 inches, such that it can travel through the
center lumen of the camera instrument. In some embodiments, the
camera can be installed and removed from the instrument without
cutting off the connector and re-soldering. The connector can
comprise a long, skinny PCB potted inside of a stainless-steel
tube, with surface pads exposed for pin engagement, as shown in
FIG. 9A. The camera cable conductors can be soldered to the PCB and
potted inside of the stainless-steel tube. The tip of the connector
can be keyed for proper installation into an adapter. The tip of
the connector can comprise female threads to accept a pull tool
(e.g. a steel cable with male fine thread tip) and be pulled
through the instrument and probe. In some embodiments, the camera
can receive power and transmit data through the instrument and
instrument drive, eliminating the need for an external
connector.
[0157] In some embodiments, the camera connector plugs into a
custom adapter unit which outputs to a standard connector (e.g. a
Lemo connector), as shown in FIGS. 9B-D. The adapter can comprise
an aluminum housing with a cylindrical channel to accept the camera
connector. The connector can be inserted until it comes to a hard
stop within the adapter and is keyed in the correct position via a
feature at its tip. Once the connector is fully inserted, the user
can tighten a screw through the top face of the adapter which
lowers a spring-loaded PCB insert. One or more spring pins on the
PCB insert can contact the connector pads as the insert is lowered
to its locked position. The PCB can be wired to a short section of
camera cable which exits the adapter and terminates to a Lemo or
other standard or custom camera connector.
[0158] In some embodiments, eleven links in the proximal joint and
the first three links in the distal articulations section of the
camera instrument are uni-directional, such that they articulate
only on one axis. The uni-directional links can achieve a tighter
radius along their articulation section versus bi-directional
links. A tighter radius can allow for the camera to move up and
away from the probe in a shorter length than bi-directional links
would allow. In some embodiments, an articulation section using
uni-directional links articulates "up" and "down", but not "left"
and "right" (e.g. relative to the orientation of the camera).
[0159] In some embodiments, the proximal cap of the camera includes
rectangular slots machined into the steel around the cable exit to
allow the "fingers" of the distal link to engage. The fingers of
the distal link can create a mechanical connection between the
camera instrument and the camera, allowing for linear and/or
rotational motion.
[0160] In some embodiments, the distal link of the camera
instrument includes chamfers on its "fingers" to allow the camera
to be removed from the instrument. The distal link can include a
slot to accept the tang on the instrument collar, which is used to
"lock" the fingers down while the camera is installed. The camera
can be removed from the distal link by rotating the collar, thereby
releasing the tang from the slot, and pushing the collar
proximally. The distal link "fingers" can be splayed open using a
small tool to disengage from the proximal cap of the camera. The
distal link is illustrated in FIGS. 10A-B.
[0161] System 10 includes a manipulation assembly 600 configured to
operably attach to a base unit 650 and articulating probe 300.
Manipulation assembly 600 can comprise a cable control assembly 610
and a position control assembly 620. Cable control assembly 610 is
configured to manipulate the tension of one or more steering
cables, for example cables 311, 351, and/or 101 described
hereabove, to articulate (e.g. steer) and/or control the rigidity
of inner probe 310, outer probe 351, and/or camera device 100,
respectively (e.g. transition each of these between limp and rigid
states). Cable control assembly 610 can comprise one or more
tensioning mechanisms, such as bobbins 615a-c shown, onto which one
or more steering cables can be wound. Each bobbin 615 can include
or otherwise be engaged with a rotational element (e.g. a motor)
configured to rotate the associated bobbin 615 in a clockwise
and/or counter-clockwise direction, such as to tension or
de-tension the associated cable (e.g. to steer and/or transition
between the limp and rigid states). In some embodiments, one or
more tools 200 can operably attach to cable control assembly 610,
such that cable control assembly 610 can robotically manipulate the
attached tool 200. Position control assembly 620 is configured to
manipulate the rotation and/or linear position of inner probe 310,
outer probe 350, a portion of camera device 100, and/or another
tool of system 10. Position control assembly 620 can comprise one
or more connector assemblies, such as connector assemblies 627a-c
(generally connector assemblies 627) shown, operably attached to
outer probe 350, camera device 100, and inner probe 310,
respectively. Connector assemblies 627 can operably attach to
linear controls 625 configured to adjust the linear position of the
attached device relative to base unit 650. Additionally or
alternatively, connector assemblies 627 can operably attach to
rotational controls 626 configured to rotate the attached device,
and/or a portion thereof (e.g. rotate an inner portion and/or the
distal portion of an attached device).
[0162] System 10 further comprises a processor 400, including one
or more algorithms, algorithm 410, for execution by processor 400,
which enable the operation of system 10. Processor 400 can further
include an imaging processing unit 420 for receiving and processing
optical signals (e.g. signals received from camera device 100),
and/or other image data. Processor 400 is operably attached to
manipulation assembly 600, camera device 100, and/or other
electronic components of system 10 via one or more data and or
power transmission conduits, for example cable 401 shown. In some
embodiments, processor 400 communicates wirelessly with one or more
components of system 10. System 10 can further comprise a console
50. Console 50 can comprise a user interface 52 configured to
receive commands from a surgeon, technician, and/or other operator
of system 10. User interface 52 can include one or more user input
devices, such as a joystick, a multi axis input device, a mouse, a
keyboard, and/or a touchscreen device. User interface 52 can
further include one or more output devices, such as a monitor,
speaker, haptic controller, and/or an indicator light. In some
embodiments, console 50 includes one or more conduits 51 (e.g.
wires, optical fibers, fluid tubes, and the like) configured to
operably attach console 50 to processor 400.
[0163] In some embodiments, user interface 52 includes a 3D
monitor, such as a 3D monitor configured to display stereoscopic
images to a user, such that the user can perceive a 3D image (or
images, such as video). In these embodiments, system 10 can include
glasses 54, such as polarized glasses configured to allow the user
to perceive the 3D image. In some embodiments, glasses 54 further
comprise lenses configured to provide protection from laser or
other energy which may be harmful to the eye.
[0164] Processor 400 can further include a movement control unit
430, further comprising a camera control unit 435. Movement control
unit 430 can receive one or more commands from console 50 (e.g.
user input commands for the steering of probe 300 and/or camera
device 100), and provide operational commands to manipulation
assembly 600 to operably control an attached device.
[0165] Referring now to FIGS. 2A-C, graphic demonstrations of an
articulating probe are illustrated, consistent with the present
inventive concepts. Articulating probe 300 comprises essentially
two concentric mechanisms, an outer mechanism and an inner
mechanism, each of which can be viewed as a steerable mechanism.
Each of the components of probe 300 can comprise one or more
sealing elements, such as to support an insufflation procedure.
FIGS. 2A-C show the concept of how different embodiments of
articulating probe 300 operate. Referring to FIG. 2A, the inner
mechanism can be referred to as a first mechanism or inner probe
310. The outer mechanism can be referred to as a second mechanism
or outer probe 350. Each mechanism can alternate between rigid and
limp states. In the rigid mode or state, the mechanism is just
that--rigid. In the limp mode or state, the mechanism is highly
flexible and thus either assumes the shape of its surroundings or
can be re-shaped. It should be noted that the term "limp" as used
herein does not necessarily denote a structure that passively
assumes a particular configuration dependent upon gravity and the
shape of its environment; rather, the "limp" structures described
in this application are capable of assuming positions and
configurations that are desired by the operator of the device, and
therefore are articulated and controlled rather than flaccid and
passive.
[0166] In some embodiments, one mechanism starts limp and the other
starts rigid. For the sake of explanation, assume outer probe 350
is rigid and inner probe 310 is limp, as seen in step 1 in FIG. 2A.
Now, inner probe 310 is pushed forward by feeder 100, and a
distal-most inner link 315D is steered, as seen in step 2 in FIG.
2A. Now, inner probe 310 is made rigid and outer probe 350 is made
limp. Outer probe 350 is then pushed forward until a distal-most
outer link 355D catches up to the distal-most inner link 315D (e.g.
outer probe 350 is coextensive with inner probe 310), as seen in
step 3 in FIG. 2A. Now, outer probe 350 is made rigid, inner probe
310 limp, and the procedure then repeats. One variation of this
approach is to have outer probe 350 be steerable as well. The
operation of such a device is illustrated in FIG. 2B. In FIG. 2B it
is seen that each mechanism is capable of catching up to the other
and then advancing one link beyond. According to one embodiment,
outer probe 350 is steerable and inner probe 310 is not. The
operation of such a device is shown in FIG. 2C.
[0167] In medical applications, operation, procedures, and so on,
once articulating probe 300 arrives at a desired location, the
operator, such as a surgeon, can slide one or more tools through
one or more working channels of outer probe 350, inner probe 310,
or one or more working channels formed between outer probe 350 and
inner probe 310, such as to perform various diagnostic and/or
therapeutic procedures. In some embodiments, the channel is
referred to as a working channel that can, for example, extend
between first recesses formed in a system of outer links and second
recesses formed in a system of inner links. Working channels may be
included on the periphery of articulating probe 300, such as
working channels comprising one or more radial projections
extending from outer probe 350, these projections including one or
more holes sized to slidingly receive one or more tools. As
described with reference to other embodiments, working channels may
be positioned on other locations extending from, on, in, and/or
within articulating probe 300.
[0168] Inner probe 310 and/or outer probe 350 are steerable and
inner probe 310 and outer probe 350 can each be made both rigid and
limp, allowing articulating probe 300 to drive anywhere in
three-dimensions while being self-supporting. Articulating probe
300 can "remember" each of its previous configurations and for this
reason, articulating probe 300 can retract from and/or retrace to
anywhere in a three-dimensional volume such as the intracavity
spaces in the body of a patient such as a human patient.
[0169] Inner probe 310 and outer probe 350 each include a series of
links, i.e. inner links 315 and outer links 355 respectively, that
articulate relative to each other. In some embodiments, outer links
355 are used to steer and lock articulating probe 300, while inner
links 315 are used to lock articulating probe 300. In a "follow the
leader" fashion, while inner links 315 are locked, outer links 355
are advanced beyond the distal-most inner link 315. Outer links 355
are steered into position by the system steering cables, and then
locked by locking the steering cables. The cable of inner links 315
is then released and inner links 315 are advanced to follow outer
links 355. The procedure progresses in this manner until a desired
position and orientation are achieved. The combined inner links 315
and outer links 355 may include working channels for temporary or
permanent insertion of tools at the surgery site. In some
embodiments, the tools can advance with the links during
positioning of articulating probe 300. In some embodiments, the
tools can be inserted through the links following positioning of
articulating probe 300.
[0170] One or more outer links 355 can be advanced beyond the
distal-most inner link 315D prior to the initiation of an operator
controlled steering maneuver, such that the quantity extending
beyond the distal-most inner link 315D will collectively articulate
based on steering commands. Multiple link steering can be used to
reduce procedure time, such as when the specificity of single link
steering is not required. In some embodiments, between 2 and 20
outer links can be selected for simultaneous steering, such as
between 2 and 10 outer links or between 2 and 7 outer links. The
number of links used to steer corresponds to achievable steering
paths, with smaller numbers enabling more specificity of curvature
of articulating probe 300. In some embodiments, an operator can
select the number of links used for steering (e.g. to select
between 1 and 10 links to be advanced prior to each steering
maneuver).
[0171] Referring now to FIGS. 3A and 3B, schematic views of the
distal portion of an articulated probe including a camera device
and a tool are illustrated, consistent with the present inventive
concepts. Probe 300 includes inner and outer probes 310 and 350,
respectively, and a camera device 100 that is slidingly positioned
within and exiting the distal end of a working channel, channel
356a of probe 300. Camera device 100 includes camera assembly 120
positioned on the distal end of an articulatable shaft, shaft 110.
Tool 200 is slidingly positioned within another working channel of
probe 300, channel 356c. Tool 200 is shown exiting channel 356c for
illustrative clarity, but can be positioned totally within channel
356c (e.g. during advancement of probe 300). In some embodiments,
one, two or more additional tools 200 (not shown but such as are
described herein) are similarly advanced through a working channel
356. Probe 300, camera device 100, tool 200, and other components
of system 10 can be of similar construction and arrangement to the
similar components described hereabove in reference to FIG. 1.
[0172] As shown in FIG. 3A, camera assembly 120 of camera device
100 has been advanced distally, away from distal link 355D, and
tool 200 has been advanced out the distal end of channel 356c, to a
location behind camera assembly 120 (advancement of tool 200 being
an optional step, not necessary at this point of the procedure).
Camera assembly 120 is still positioned within region PPRJ of probe
300. In FIG. 3B, articulating portion 111 of shaft 110 has been
articulated in a first direction away from the central axis Ai of
probe 300, and articulating portion 112 has been articulated back,
towards central axis Ai, or otherwise oriented towards a target
location. In this embodiment, all articulation of shaft 110 occurs
distal to the distal end of probe 300. The positioning of camera
assembly 120 in FIG. 3B provides an optimized view of the target
location and the one or more tools 200 exiting probe 300.
[0173] Referring now to FIGS. 4A and 4B, schematic views of the
distal portion of an articulated probe including a slotted distal
portion, a camera device, and a tool are illustrated, consistent
with the present inventive concepts. Probe 300 includes inner and
outer probes 310 and 350, respectively, and a camera device 100
that is slidingly positioned within and exiting the distal end of a
working channel, channel 356a of probe 300. Camera device 100
includes camera assembly 120 positioned on the distal end of an
articulatable shaft, shaft 110. Tool 200 is slidingly positioned
within another working channel of probe 300, channel 356c. Tool 200
is shown exiting channel 356c for illustrative clarity, but can be
positioned totally within channel 356c (e.g. during advancement of
probe 300). In some embodiments, one, two or more additional tools
200 (not shown but such as are described herein) are similarly
advanced through a working channel 356. Probe 300, camera device
100, tool 200, and other components of system 10 can be of similar
construction and arrangement to the similar components described
hereabove in reference to FIG. 1.
[0174] As shown in FIG. 4A, camera assembly 120 of camera device
100 has been advanced distally, away from distal link 355D, and
tool 200 has been advanced out the distal end of channel 356c, to a
location behind camera assembly 120 (advancement of tool 200 being
an optional step, not necessary at this point of the procedure).
Camera assembly 120 is still positioned within region PPRJ of probe
300.
[0175] In some embodiments, distal portion 301 includes an elongate
opening, slot 3561 as shown, between the outer surface of outer
probe 350 and working channel 356a. In these embodiments, shaft 110
of camera device 100 can articulate through slot 3561, allowing
articulation of shaft 110 to begin at locations proximal to the
distal end of probe 300, allowing the orientation of camera
assembly 120 toward target locations relatively close to the distal
end of probe 300 (e.g. camera assembly 120 can image target
locations closer to the distal end of probe 300 than those that
could be imaged in the non-slotted configurations of FIGS. 3A-B).
For example, as shown in FIG. 4B, articulating portion 111 of shaft
110 has been articulated in a first direction away from the central
axis Ai of probe 300 at a location proximal to the distal end of
probe 300. Articulating portion 112 has been articulated back,
towards central axis Ai, or otherwise oriented towards a target
location relatively proximate the distal end of probe 300. The
positioning of camera assembly 120 in FIG. 4B provides an optimized
view of the target location and the one or more tools 200 exiting
probe 300, yet relatively close to probe 300.
[0176] Referring now to FIGS. 5A-D, a sequence of schematic
drawings of advancing a camera device from a confined space are
illustrated, consistent with the present inventive concepts. Probe
300 includes inner and outer probes 310 and 350, respectively, and
a camera device 100 that is slidingly positioned within and exiting
the distal end of a working channel, channel 356a of probe 300.
Camera device 100 includes camera assembly 120 positioned on the
distal end of an articulatable shaft, shaft 110. Tool 200 is
slidingly positioned within another working channel of probe 300,
channel 356c. In some embodiments, one, two or more additional
tools 200 (not shown but such as are described herein) are
similarly advanced through a working channel 356. Probe 300, camera
device 100, tool 200, and other components of system 10 can be of
similar construction and arrangement to the similar components
described hereabove in reference to FIG. 1.
[0177] As shown in FIG. 5A, probe 300 is positioned within a body
space, lumen L, with camera assembly 120 positioned proximate
distal link 355D (e.g. camera assembly 120 is relatively in contact
with distal link 355D), and within region PPRJ of probe 300. In
FIG. 5B, probe 300 has been advanced through lumen L towards a
target location, camera device 100 has been advanced away from
distal link 355D, and tool 200 has been slightly advanced from
channel 356c. In some embodiments, the rotation and/or positioning
of camera assembly 120 (e.g. via rotation and/or articulation of
shaft 110), as shown in FIGS. 5C and 5D, occurs before tool 200 (or
multiple tools 200) are advanced out the distal end of probe 300
(e.g. such as when system 10 prevents advancement of a tool 200
until rotation of camera assembly 120 to an outwardly rotated
position has occurred). Tool 200 is shown partially advanced in
FIGS. 5B and 5C primarily for illustrative clarity. Additionally,
the rotation of camera assembly 120 shown in FIG. 5C can occur in
the proximal most position of camera assembly 120 shown in FIG. 5A.
Again, camera assembly 120 is shown advanced in FIGS. 5B and 5C
primarily for illustrative clarity.
[0178] As shown in FIG. 5C, camera assembly 120 has been rotated,
to an outwardly rotated position (e.g approximately 180.degree. as
shown), out of the region PPRJ, allowing further advancement of
tool 200. In some embodiments, a target location is located within
or proximate region PPRJ. In these embodiments, after camera
assembly 120 has rotated to allow tool 200 to exit beyond channel
356c, a surgical or other medical procedure ("surgical procedure"
or "medical procedure" herein) can be performed in the
configuration shown, as tool 200 extends beyond camera assembly 120
towards the target location.
[0179] Additionally or alternatively, as shown in FIG. 5D, camera
device 100 can be extended and articulated, to be positioned
"above" the target location, such as to provide an optimal viewing
angle for the operator to perform the medical procedure.
[0180] Referring now to FIG. 6, a perspective view of a probe
system including a camera device and multiple tools in a
triangulated position is illustrated, consistent with the present
inventive concepts. Probe 300 includes inner and outer probes 310
and 350, respectively, and a camera device 100 that is slidingly
positioned within and exiting the distal end of a working channel,
channel 356a of probe 300. Camera device 100 includes camera
assembly 120 positioned on the distal end of an articulatable
shaft, shaft 110. Three tools, tools 200a-c are shown, each
slidingly positioned within and exiting the distal end of a
separate working channel of probe 300, channels 356b-d. In some
embodiments, more or fewer tools 200 are included (such as are
described herein), each tool similarly advanced through a working
channel 356. Tools 200a-c can include various end effectors, such
as end effectors 205a-c shown. Probe 300, camera device 100, tool
200, and other components of system 10 can be of similar
construction and arrangement to the similar components described
hereabove in reference to FIG. 1.
[0181] As shown in FIG. 6, probe 300 has been advanced along a
tortuous, three-dimensional path, towards a target location, for
example a target location to perform a surgery or other medical
procedure within the body of a patient. In some embodiments, probe
300 can be advanced through a natural orifice, such as the vagina,
or through a surgical incision, such as an incision into the
abdomen of the patient, and advanced into a larger body cavity
(e.g. larger than the opening of the orifice), such as to perform
transvaginal and/or transabdominal surgery. Within this larger body
cavity, camera device 100, and/or one or more tools 200 (tools
200a-c shown), can have available "space" to extend away (e.g.
radially away) from the distal end of probe 300 (e.g. out of region
PPRJ described herein), such as to triangulate on a target
location, such that camera assembly 120 provides an optimal view of
the target location, and tools 200 assume an "operator-like"
anatomic position (e.g. the position of tools 200 mimic the
position of the operator's hands on the controls, control 53
described herein).
[0182] Referring now to FIGS. 7A and 7B, perspective views of a
camera from the front and back are illustrated, consistent with the
present inventive concepts.
[0183] Referring now to FIGS. 8A and 8B, perspective views of a
camera operably attached to a surgical tool are illustrated,
consistent with the present inventive concepts.
[0184] Referring now to FIG. 9A, a perspective view of a camera
connector is illustrated, consistent with the present inventive
concepts.
[0185] Referring now to FIGS. 9B-D, perspective views of a camera
cable adaptor are illustrated, consistent with the present
inventive concepts.
[0186] Referring now to FIGS. 10A and 10B, a perspective view and a
sectional perspective view of a distal link are illustrated,
respectively, consistent with the present inventive concepts.
[0187] The above-described embodiments should be understood to
serve only as illustrative examples; further embodiments are
envisaged. Any feature described herein in relation to any one
embodiment may be used alone, or in combination with other features
described, and may also be used in combination with one or more
features of any other of the embodiments, or any combination of any
other of the embodiments. Furthermore, equivalents and
modifications not described above may also be employed without
departing from the scope of the invention, which is defined in the
accompanying claims.
* * * * *